Zhou Ping, Jin Chan-Hui, Shi Ying, Ma Guo-Qing, Wu Wen-Hao, Wang Yu, Cai Kun, Fan Wu-Feng, Wang Tian-Bao
Department of Gastrointestinal Surgery, South China Hospital of Shenzhen University, Shenzhen 518000, Guangdong Province, China.
World J Clin Cases. 2024 Feb 16;12(5):988-994. doi: 10.12998/wjcc.v12.i5.988.
The most common causes of scrotal enlargement in patients include primary tumor of the scrotum, inflammation, hydrocele of the tunica vaginalis, and indirect inguinal hernia; scrotal enlargement caused by external tumors of the scrotum is rare. The patient had both a greater omentum tumor and an inguinal hernia, and the tumor protruded into the scrotum through the hernia sac, which is even rarer. Moreover, omental tumors are mostly metastatic, and primary omental fibroma is rare.
Here, we report a rare case of a 25-year-old young man with scrotal enlargement and pain for 3 months. Preoperative examination and multidisciplinary discussions considered intra-abdominal tumor displacement and inguinal hernia, and intraoperative exploration confirmed that the greater omentum tumor protruded into the scrotum. Therefore, tumor resection and tension-free inguinal hernia repair were performed. The final diagnosis was benign fibroma of the greater omentum accompanied by an indirect inguinal hernia.
This unusual presentation of a common inguinal hernia disease illustrates the necessity of performing detailed history taking, physical examination, and imaging before surgery.
患者阴囊增大的最常见原因包括阴囊原发性肿瘤、炎症、鞘膜积液和腹股沟斜疝；由阴囊外部肿瘤引起的阴囊增大较为罕见。该患者同时患有大网膜肿瘤和腹股沟疝，肿瘤通过疝囊突入阴囊，这种情况更为罕见。此外，大网膜肿瘤大多为转移性，原发性大网膜纤维瘤罕见。
在此，我们报告一例罕见病例，一名25岁青年男性阴囊增大伴疼痛3个月。术前检查及多学科讨论考虑为腹腔内肿瘤移位及腹股沟疝，术中探查证实大网膜肿瘤突入阴囊。因此，行肿瘤切除及无张力腹股沟疝修补术。最终诊断为大网膜良性纤维瘤伴腹股沟斜疝。
这种常见腹股沟疝疾病的不寻常表现说明了术前进行详细病史采集、体格检查和影像学检查的必要性。
